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Is A Negative HIV Test Done At 3 Months Conclusive?
Question: HI i tested for hiv from dr lal path for hiv1/2 antibodies and p24 antigens. test was done after 3 months of exposure, negative with index value 0.05. again got tested after 4 months with the same test and result came negative with index value 0.07. Now most of the people are saying it is conclusive but my gyanec said that 6 months test should be taken as a confirmed result. I am really upset, scared and frustrated as it is scaring the hell out of me thinking of waiting till 6 months. And have certain other queries like in which cases window period extends? i have asthma and in XXXXXXX 2014 i was on montec lc for one month and used to take inhaler too. exposure happened in April, does these medication prolongs hiv window period?
Brief Answer:
You are negative for HIV
Detailed Answer:
Hello
I understand your concern and your worry very well. I am Dr. Arun Tank & I am infectious disease specialist. I am going to handle your query.
-P24 antigen test is the second earliest confirmatory test after PCR in case of HIV. It will detect both HIV 1 & 2. P24 antigen test will be positive after 2-8 weeks after exposure to HIV.
-You had been declared negative by one of the good laboratory in the XXXXXXX As you have been negative by this test you are negative for it even after six months. So do not worry and be tension free. You have undergone it for two times so there is no question of false negative. and you are surely a negative by P24 antigen test.
-Window period is the period where there is no detectable antibodies in the body. It usually affects the tests based on antibody detection e.g. tridot test. But it will not affect the tests based on P24 antigen. Window period will depends on individuals immunity & health. usually it is usually 12 weeks but may be long in some cases. It is not affected at all by the use of drugs, in other words it has nothing to do with drugs.
It will be great to answer any query from you. Feel free to ask if you have anything to ask. We wish you a very best health at health care magic.
Thank you,
Dr. Arun Tank
If you are satisfied with answer kindly rate me five star and close the query
You are negative for HIV
Detailed Answer:
Hello
I understand your concern and your worry very well. I am Dr. Arun Tank & I am infectious disease specialist. I am going to handle your query.
-P24 antigen test is the second earliest confirmatory test after PCR in case of HIV. It will detect both HIV 1 & 2. P24 antigen test will be positive after 2-8 weeks after exposure to HIV.
-You had been declared negative by one of the good laboratory in the XXXXXXX As you have been negative by this test you are negative for it even after six months. So do not worry and be tension free. You have undergone it for two times so there is no question of false negative. and you are surely a negative by P24 antigen test.
-Window period is the period where there is no detectable antibodies in the body. It usually affects the tests based on antibody detection e.g. tridot test. But it will not affect the tests based on P24 antigen. Window period will depends on individuals immunity & health. usually it is usually 12 weeks but may be long in some cases. It is not affected at all by the use of drugs, in other words it has nothing to do with drugs.
It will be great to answer any query from you. Feel free to ask if you have anything to ask. We wish you a very best health at health care magic.
Thank you,
Dr. Arun Tank
If you are satisfied with answer kindly rate me five star and close the query
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Dr XXXXXXX many thanks for your reply. I have few more queries and they given below:
1. Does P24 looks for both HIV 1 and 2? how quickly they develop in blood? I have read that after reaching their peak they just vanish from the blood, what if the p24 disappears and there would be sometime in antibodies to develop and someone get tested during this phase, and test come back as negative due to P24 no more in the blood and antibodies have not developed yet? I am putting my test in such situation. Can you explain as to after how long gap antibodies produces after P24 antigen. And what if p24 also appear late in the blood, like after 4 months due to delayed seroconversion and this could not catch the correct result.
2. I went to Dr lal path for HIV test last month, the guy who took blood sample of mine had put the cotton on slab after rubbing on my skin with antiseptic, for puncturing and again used the same cotton on me, what if there would be some HIV infected blood on the slab with which that cotton got contaminated and when he rubbed it back on my punctured skin after taking blood, chances of me getting infected with the blood on cotton. I know i am being paranoid but this is important to me as this is also giving me sleepless night.( please don't confuse this with the exposure 4 months back, it was with my fiance who cheated on me and i called off the marriage).
3. Does these paths (especially renowned like lal path) do such kind of ignorance which could lead to such infectious disease to patients during blood sampling and all.
4. In how many people nowadays you guys see late seroconversion that is after 4 months or so?
5. When you say HIV window period prolongs in some people with low immunity like having auto immune disorder, cancer or organ transplant, is there anything apart from this which causes low immunity. How would i know i have low immunity,have asthma problem which only triggers in winters (but not always).
6. Have you confront anyone whose window period was more than four months?
7. Do i need further testing? or should i take it as conclusive?
Regards, XXXXXXX
1. Does P24 looks for both HIV 1 and 2? how quickly they develop in blood? I have read that after reaching their peak they just vanish from the blood, what if the p24 disappears and there would be sometime in antibodies to develop and someone get tested during this phase, and test come back as negative due to P24 no more in the blood and antibodies have not developed yet? I am putting my test in such situation. Can you explain as to after how long gap antibodies produces after P24 antigen. And what if p24 also appear late in the blood, like after 4 months due to delayed seroconversion and this could not catch the correct result.
2. I went to Dr lal path for HIV test last month, the guy who took blood sample of mine had put the cotton on slab after rubbing on my skin with antiseptic, for puncturing and again used the same cotton on me, what if there would be some HIV infected blood on the slab with which that cotton got contaminated and when he rubbed it back on my punctured skin after taking blood, chances of me getting infected with the blood on cotton. I know i am being paranoid but this is important to me as this is also giving me sleepless night.( please don't confuse this with the exposure 4 months back, it was with my fiance who cheated on me and i called off the marriage).
3. Does these paths (especially renowned like lal path) do such kind of ignorance which could lead to such infectious disease to patients during blood sampling and all.
4. In how many people nowadays you guys see late seroconversion that is after 4 months or so?
5. When you say HIV window period prolongs in some people with low immunity like having auto immune disorder, cancer or organ transplant, is there anything apart from this which causes low immunity. How would i know i have low immunity,have asthma problem which only triggers in winters (but not always).
6. Have you confront anyone whose window period was more than four months?
7. Do i need further testing? or should i take it as conclusive?
Regards, XXXXXXX
Brief Answer:
By your nature you should think for PCR
Detailed Answer:
Hello XXXX, I will be happy to answer all of your concern.
mentioning you answer step by step as you questioned by numbers I am answering by same numbers.
1. Yes P 24 looks for both HIV 1& 2. It usually appears after approx 2 to 8 weeks. But may prolonged in some cases depending on various host parameters. Yes its the drawback of this test it may not detect antibodies against P24 whenever P24 has not developed or it may be disappear. But it is not always a case same way for you. I had seen only one such case in 4 years. For such a person we advice HIV PCR. It gives definite diagnosis.
2. HIV wont spread by such a manner as you are asking. HIV actually very sensitive to atmospheric changes it want live in free state as in our case on the platform. Definately their practice for using such a cotton that had on paltform was wrong. I oppose such a practise. Because other bacterial contamination may enter into your blood stream and cause you septicemia if you are vulnerable host.
3. But be sure in case where serious disease like HIV comes in question they wont play such mistakes. So dont worry for that.
4. Such a late seroconversion is rarely observed in patients. I can say 1 in 10000.
5. Apart from the disease you have mentioned severly malnourished person can also have long window period. Low immunity is generally identified by some symptoms like prolonged diarrhea, prolong cough without reason, extensive fungal infection etc. Having asthma wont put you in such a category.
6. Yes have observed one prolonged window period in one patient in this four years.
7. By not considering you in abonormal case you do not require further testing and you can be conclusive for not having HIV.
-But I consider your nature is some what more panic than the usual cases, please do not take me other wise. I am little straight speaking person. I advice you should think for PCR tests. It will make you more tension free.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
By your nature you should think for PCR
Detailed Answer:
Hello XXXX, I will be happy to answer all of your concern.
mentioning you answer step by step as you questioned by numbers I am answering by same numbers.
1. Yes P 24 looks for both HIV 1& 2. It usually appears after approx 2 to 8 weeks. But may prolonged in some cases depending on various host parameters. Yes its the drawback of this test it may not detect antibodies against P24 whenever P24 has not developed or it may be disappear. But it is not always a case same way for you. I had seen only one such case in 4 years. For such a person we advice HIV PCR. It gives definite diagnosis.
2. HIV wont spread by such a manner as you are asking. HIV actually very sensitive to atmospheric changes it want live in free state as in our case on the platform. Definately their practice for using such a cotton that had on paltform was wrong. I oppose such a practise. Because other bacterial contamination may enter into your blood stream and cause you septicemia if you are vulnerable host.
3. But be sure in case where serious disease like HIV comes in question they wont play such mistakes. So dont worry for that.
4. Such a late seroconversion is rarely observed in patients. I can say 1 in 10000.
5. Apart from the disease you have mentioned severly malnourished person can also have long window period. Low immunity is generally identified by some symptoms like prolonged diarrhea, prolong cough without reason, extensive fungal infection etc. Having asthma wont put you in such a category.
6. Yes have observed one prolonged window period in one patient in this four years.
7. By not considering you in abonormal case you do not require further testing and you can be conclusive for not having HIV.
-But I consider your nature is some what more panic than the usual cases, please do not take me other wise. I am little straight speaking person. I advice you should think for PCR tests. It will make you more tension free.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Dr XXXXXXX
Thanks for replying my queries. I want to make my brain understand each and every minute detail so that it stop worrying and that's the reason i have joined this forum and its helping :)
1. I read on various hiv sites that antibodies develops to kill P24 antigen, so if P24 will vanish from the blood then it means there are antibodies which have killed the p24 antigen. So with the help of combo test both P24 and antibodies can be detected .From this i understand, in case P24 would be very less in the blood then it would mean that there are enough antibodies which can be detected from the test or if antibodies are less to detect then there would be enough P24 which can be detected from the combo test. It seems that is the reason combo test has reduced the window period to one month, although CDC guidelines are to get tested after 3 months for conclusive result. So with the combo test anybody testing after 90 days of exposure will be conclusive. Am i correct in saying this?
2. So, if i put myself in the above situation even if i assume that my immunity is worse then also i would have showed p24 in the blood after four months. As the way i see it- once the virus enters into the body it starts making p24 in the blood. But is it possible that virus does not make any p24 antigen even after 4 months i.e 120 days. Is there any chance pf p24 start developing in the 5 month.
3.I just want to understand the process of P24 and antibodies. Is there any time lag between the disappearance of p24 and appearance of antibodies. For eg- if someone gets infected and shows p24 in the blood but they disappear after 20 days and antibodies will start developing on 30th day, what if the person get tested between this time lag i.e between 20th & 30th day (duration of 10 days) . the combo test wont be able to detect the p24 as they are not their and antibodies as they have not developed yet. Is this scenario possible.
4. The case which you have mentioned has been tested positive after how many months and by which test?
5. I know Dr i am panicking so i do not feel bad for what you said. actually my whole life has gone upside and down and i am not able to concentrate on my work also. I cant see me so miserable. sometimes i feel i am having an anxiety disorder. i would certainly visit a psychiatrist.
But before going there i need to make my mind understand everything as knowledge can only set you free from all the crap. I felt my questions will be answered here so joined this forum. thanks for providing the facts and helping me.
6. I can get the PCR but it has a chance of showing false positive and i dont want to undergo that trauma and secondly it only looks for HIV1, although i know HIV 2 is uncommon but still.
7. I am planning to get tested again at the end of 5th month. do i need the testing or its unnecessary? what are my chances of being negative?
8. What do you say about if a person get positive by the end of 6 month will he have enough p24 after the end of 4th month, which can be detected through combo test.
Thanks for bearing with me and in anticipation for answering me queries,
Thanks for replying my queries. I want to make my brain understand each and every minute detail so that it stop worrying and that's the reason i have joined this forum and its helping :)
1. I read on various hiv sites that antibodies develops to kill P24 antigen, so if P24 will vanish from the blood then it means there are antibodies which have killed the p24 antigen. So with the help of combo test both P24 and antibodies can be detected .From this i understand, in case P24 would be very less in the blood then it would mean that there are enough antibodies which can be detected from the test or if antibodies are less to detect then there would be enough P24 which can be detected from the combo test. It seems that is the reason combo test has reduced the window period to one month, although CDC guidelines are to get tested after 3 months for conclusive result. So with the combo test anybody testing after 90 days of exposure will be conclusive. Am i correct in saying this?
2. So, if i put myself in the above situation even if i assume that my immunity is worse then also i would have showed p24 in the blood after four months. As the way i see it- once the virus enters into the body it starts making p24 in the blood. But is it possible that virus does not make any p24 antigen even after 4 months i.e 120 days. Is there any chance pf p24 start developing in the 5 month.
3.I just want to understand the process of P24 and antibodies. Is there any time lag between the disappearance of p24 and appearance of antibodies. For eg- if someone gets infected and shows p24 in the blood but they disappear after 20 days and antibodies will start developing on 30th day, what if the person get tested between this time lag i.e between 20th & 30th day (duration of 10 days) . the combo test wont be able to detect the p24 as they are not their and antibodies as they have not developed yet. Is this scenario possible.
4. The case which you have mentioned has been tested positive after how many months and by which test?
5. I know Dr i am panicking so i do not feel bad for what you said. actually my whole life has gone upside and down and i am not able to concentrate on my work also. I cant see me so miserable. sometimes i feel i am having an anxiety disorder. i would certainly visit a psychiatrist.
But before going there i need to make my mind understand everything as knowledge can only set you free from all the crap. I felt my questions will be answered here so joined this forum. thanks for providing the facts and helping me.
6. I can get the PCR but it has a chance of showing false positive and i dont want to undergo that trauma and secondly it only looks for HIV1, although i know HIV 2 is uncommon but still.
7. I am planning to get tested again at the end of 5th month. do i need the testing or its unnecessary? what are my chances of being negative?
8. What do you say about if a person get positive by the end of 6 month will he have enough p24 after the end of 4th month, which can be detected through combo test.
Thanks for bearing with me and in anticipation for answering me queries,
Brief Answer:
Every tests has pros and cons
Detailed Answer:
HelloXXXX
I will be happy to answer you. Good to hear that you are interested in knowing the pathogenesis of HIV. You can make knowledgeable by this chat that is my sincere request to you.
Now I am covering your concern one by one.
1.Yes for the first point you are absolutely right.
2. P24 antigen are the constitutional protein of the HIV virus. e.g. hands and legs in us. So there is no question of it being late to develop. If HIV replication has been started than P24 must be there to get detected.
3. No such scenario never happens, because antigen and antibodies are complimentary to each other one develops and simultaneously other will disappear. Consider the scenario P24 are there in blood antibodies develop against them they will bind with antigen and so they disappear.
4. In that case its been a long period I dont rember exact period but it is approx a four to five years. We are suspecting AIDS but the testing came positive. So we confirmed by PCR. It came positive after a five years or so antibody test came positive.
5. Yes visiting psychiatrist would certainly help you. We have a psychiatrist in our HIV treating team. They will give mental support to those who are depressed.
6. Yes that draw back is there. But think that in the world nothing is perfect so the laboratory tests. I had been pricked by needle of HIV positive needle I had been tested by P24 antigen at one month after taking PEP. It came negative and I consider it as negative. There is no question of thinking like I am false negative. Do not loss positivity in you.
7. I consider its useless. But you can think with your own.
8. The chances are very less. But human body are mysterious box nothing can be predected.
You can ask me even if something is there in your mind.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
Every tests has pros and cons
Detailed Answer:
HelloXXXX
I will be happy to answer you. Good to hear that you are interested in knowing the pathogenesis of HIV. You can make knowledgeable by this chat that is my sincere request to you.
Now I am covering your concern one by one.
1.Yes for the first point you are absolutely right.
2. P24 antigen are the constitutional protein of the HIV virus. e.g. hands and legs in us. So there is no question of it being late to develop. If HIV replication has been started than P24 must be there to get detected.
3. No such scenario never happens, because antigen and antibodies are complimentary to each other one develops and simultaneously other will disappear. Consider the scenario P24 are there in blood antibodies develop against them they will bind with antigen and so they disappear.
4. In that case its been a long period I dont rember exact period but it is approx a four to five years. We are suspecting AIDS but the testing came positive. So we confirmed by PCR. It came positive after a five years or so antibody test came positive.
5. Yes visiting psychiatrist would certainly help you. We have a psychiatrist in our HIV treating team. They will give mental support to those who are depressed.
6. Yes that draw back is there. But think that in the world nothing is perfect so the laboratory tests. I had been pricked by needle of HIV positive needle I had been tested by P24 antigen at one month after taking PEP. It came negative and I consider it as negative. There is no question of thinking like I am false negative. Do not loss positivity in you.
7. I consider its useless. But you can think with your own.
8. The chances are very less. But human body are mysterious box nothing can be predected.
You can ask me even if something is there in your mind.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doctor XXXXXXX
Thanks for your reply.
I did not understand the point 4 of yours. Did you mean that person initially came negative after 3 or 6 months but after getting the PCR done(in the same duration) he came positive. But in this case we would not be knowing the exposure date, right?
The worry is not leaving me still even after getting combo test twice after 3 months and 4 months. Can you suggest the virus detection test for both HIV 1 and HIV 2 which can directly detects the virus and rest my ghost that i dont have hiv and no further testing required. And please do tell me the best HIV specialist in XXXXXXX if you know, so i can consult someone in person.
Thanks for your help.
Regards
Thanks for your reply.
I did not understand the point 4 of yours. Did you mean that person initially came negative after 3 or 6 months but after getting the PCR done(in the same duration) he came positive. But in this case we would not be knowing the exposure date, right?
The worry is not leaving me still even after getting combo test twice after 3 months and 4 months. Can you suggest the virus detection test for both HIV 1 and HIV 2 which can directly detects the virus and rest my ghost that i dont have hiv and no further testing required. And please do tell me the best HIV specialist in XXXXXXX if you know, so i can consult someone in person.
Thanks for your help.
Regards
Brief Answer:
You can think for Westerb Blot analysis
Detailed Answer:
Hello XXXX,
-Yes you are right. Though antibody test is negative, you could know the result by PCR test.
-Exposure date for HIV is not known by the tests.
-You can think for Western Blot analysis. It will detect whole antigen structure of the HIV virus in a strip that will be kept for reference purpose.
-I am not from the XXXXXXX so I dont know about it. But you can get that from your local General Doctors.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
You can think for Westerb Blot analysis
Detailed Answer:
Hello XXXX,
-Yes you are right. Though antibody test is negative, you could know the result by PCR test.
-Exposure date for HIV is not known by the tests.
-You can think for Western Blot analysis. It will detect whole antigen structure of the HIV virus in a strip that will be kept for reference purpose.
-I am not from the XXXXXXX so I dont know about it. But you can get that from your local General Doctors.
If you have anything else to ask I will be very happy to answer that. We wish you a best health at healthcare magic.
Thank you,
Dr. Arun Tank
If you are satisfied with my answer rate me as five star and close the answer
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Above answer was peer-reviewed by :
Dr. Yogesh D
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